NPIMap

Organization Active NPI

Harrisburg Endoscopy & Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Harrisburg, PA
National Provider Identifier
1326097536
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
11431500 Issued in PA
Legal business name
HARRISBURG ENDOSCOPY & SURGERY CENTER, INC.
Practice address
4760 Union Deposit Rd
Suite 110
Harrisburg, PA 17111-3729
Phone
(717) 545-8525
Fax
(717) 545-7388
NPI assigned
May 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. William Rhoades, CASC
Title
Coo
Phone
(717) 545-8525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 11431500 PA Primary

Addresses

Primary practice location

4760 Union Deposit Rd
Suite 110
Harrisburg, PA 17111-3729

Mailing address

4760 Union Deposit Rd
Suite 110
Harrisburg, PA 17111-3729
Phone (717) 545-8525

Other identifiers 2

IdentifierTypeStateIssuer
001847195002MedicaidPA
11431500OtherPASTATE ASF LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110128000922 PA Part B Supplier - Ambulatory Surgical Center 1456530997 Practice locations: Harrisburg, PA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Harrisburg Endoscopy and Surgery Center IncCCN 39C0001093
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0991576Harrisburg Endoscopy & Surgery Center4760 Union Deposit Road, Harrisburg, PA 17111Certificate of waiverSep 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1326097536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 UNION DEPOSIT RD",
            "address_2": "SUITE 110",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113729",
            "telephone_number": "717-545-8525",
            "fax_number": "717-545-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 UNION DEPOSIT RD",
            "address_2": "SUITE 110",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113729",
            "telephone_number": "717-545-8525",
            "fax_number": "717-545-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISBURG ENDOSCOPY & SURGERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "RHOADES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "717-545-8525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "11431500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001847195002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ASF LICENSE #",
            "identifier": "11431500",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.